Provider Demographics
NPI:1194424028
Name:WARD, MONIQUE FULSHON
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:FULSHON
Last Name:WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-4493
Mailing Address - Country:US
Mailing Address - Phone:984-528-8787
Mailing Address - Fax:
Practice Address - Street 1:300 MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-4493
Practice Address - Country:US
Practice Address - Phone:984-528-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst